Hint: Social distancing, self-quarantining and good health administration were key.
(CN) — With 450,000 political prisoners — primarily Polish Jews — crammed into a 1.3-square mile area, the Warsaw Ghetto was the largest Nazi confinement zone of World War II. By all accounts it was a miserable place, with meager rations, poor sanitation and rampant fear.
Then in 1941, a typhus epidemic hit and thousands started dying.
"With poor conditions, rampant starvation and a population density 5 to 10 times higher than any city in the world today, the Warsaw Ghetto presented the perfect breeding ground for bacteria to spread typhus and it ripped through the mainly Jewish population there like a wildfire,” Lewi Stone, a mathematician, disease modeler and professor at RMIT University in Australia and Tel Aviv University, said in a statement. “Of course, the Nazis were well aware this would happen.”
More than 120,000 prisoners were infected by typhus, with 30,000 dying directly from it and others from starvation.
"Then, in October 1941, as a harsh winter was beginning and just as typhus rates would be expected to skyrocket, the epidemic curve suddenly and unexpectedly nose-dived to extinction," Stone said. "It was inexplicable at the time and many thought it was a miracle or irrational."
Stone called it a classic case of disease being used as a weapon of war and as a pretext for genocide.
So what kept the bacterial disease spread by lice from killing countless others trapped in the ghetto? It’s a question Stone sought to answer in a study with collaborators from Hong Kong, Amsterdam and Berlin.
Stone’s study uses mathematical modeling of typhus infections in the ghetto to understand how public health interventions eradicated the disease. Researchers discovered that health programs and social distancing practices are the most likely explanations for the epidemic's collapse, highlighting the importance of communal cooperation to defeat epidemics and pandemics such as Covid-19.
Modeling and statistical analysis show the epidemic was on track to kill three times as many people and expected to peak in the middle of the brutal Polish winter.
"Fortunately, many of the anti-epidemic activities and interventions are documented and it turns out that Warsaw Ghetto had many experienced doctors and specialists," Stone explained.
Combing rare historical documents, Stone found evidence of training courses on hygiene and infectious diseases, as well as public lectures on typhus and an underground medical university. Social distancing in the Warsaw Ghetto was considered common sense and home quarantining occurred routinely, he said.
"In the end, it appears that the prolonged determined efforts of the ghetto doctors and anti-epidemic efforts of community workers paid off," Stone said. “There is no other way we can find to explain the data."
The findings of Stone’s study were validated by Holocaust historian Stephan Lenstaedt from Touro College in Berlin, who noted that historian Israel Gutman wrote "while almost 100,000 ghetto residents died mostly from starvation and disease in the period up until July 1942, a similar or greater number were saved thanks to the dedicated relief workers and self-help relief agencies."
While Stone was encouraged by the study findings, he noted the irony in so many lives saved in the Warsaw Ghetto.
"The tragedy, of course, is that almost all of those lives saved through these sacrifices, discipline and community programs would soon end in extermination at the Nazi death camps,” he said.
One thing everyone involved in the study agrees on: lessons learned in the Warsaw Ghetto from a disease less contagious but more deadly than Covid-19 are relevant today.
"Today, more than ever, society needs to grasp how the damage caused by a tiny virus or bacteria can create utter havoc, dragging humankind to the terminal point of evil as witnessed over the Holocaust," Stone said.
Study co-author Yael Artzy-Randrup, a theoretical ecologist from the University of Amsterdam, went a step further.
"As those in the Warsaw Ghetto demonstrated, however, the actions of individuals in practicing hygiene, social distancing and self-isolating when sick, can make a huge difference within the community to reduce the spread,” Artzy-Randrup said.
The study, “Extraordinary curtailment of massive typhus epidemic in the Warsaw Ghetto,” is published in Science Advances.
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